Prognostı̇k Nutrı̇syonel İndeks Juvenil İdı̇yopatı̇k Artrı̇tte Prognostik Biyobelirteç Olabilir Mi?

Yıl 2025, Cilt: 47 Sayı: 1, 140 - 145, 17.01.2025

Emine Nur Sunar Yayla , Elif Arslanoğlu Aydın , Bahar Demirbaş , Ezgi Yılmazer Yönder , Esra Bağlan , Semanur Özdel

Öz

Bu çalışma, jüvenil idiyopatik artrit (JİA) hastalarında hastalık aktivitesi ile prognostik nutrisyonel indeks (PNI) arasındaki ilişkiyi incelemeyi amaçlamaktadır. Ayrıca, PNI’nın JİA’da prognostik bir biyobelirteç olarak kullanılabilirliğini değerlendirmek hedeflenmiştir. Oligoartiküler ve poliartiküler JİA tanısı alan hastalar, Jüvenil Artrit Hastalık Aktivite Skoru (JADAS) ölçümüne göre remisyon ve düşük hastalık aktivitesine sahip olanlar ile orta ve yüksek hastalık aktivitesi gösterenler olmak üzere iki gruba ayrıldı. İki grup arasında demografik, klinik ve laboratuvar özellikler ile PNI değerleri karşılaştırıldı. Çalışmaya, oligoartiküler ve poliartiküler JİA tanılı 106 hasta dahil edildi. Hastaların ortanca yaşı 5,95 yıl olup, 67’si (%63,2) kızdır. Üveit 18 hastada (%17), aile öyküsü ise 14 hastada (%13,2) gözlenmiştir. Hastaların üçte ikisi (n=69) oligoartiküler, %33,1’i (n=35) poliartiküler JİA tanısına sahiptir. On ikinci ay JADAS skoruna göre, remisyon/düşük hastalık aktivitesindeki hastalar (Grup 1) ile orta/yüksek hastalık aktivitesindeki hastalar (Grup 2) olarak iki grup oluşturulmuştur. Grup 1’de 52 hastaya (%58,4), grup 2’de ise 16 hastaya (%94,1) kortikosteroid tedavisi uygulanmıştır. Biyolojik DMARD kullanımı ise grup 2’de anlamlı derecede yüksektir ve en sık tercih edilen ajan etanersepttir. Hastaların 9’unda (%11,4) biyolojik DMARD değişikliği yapılırken, 15’inde (%14,2) tedavisiz remisyon sağlanmıştır. Ortanca PNI değeri gruplar arasında anlamlı fark göstermemiştir. PNI, JİA’lı hastalarda hastalık aktivitesini yansıtmakta yetersiz kalmaktadır ve prognoz tahmininde kullanışsız bir parametredir.

Anahtar Kelimeler

Gençlik idiyopatik artriti, prognoz, prognostik beslenme indeksi

Is The Prognostic Nutritional Index A Potential Prognostic Biomarker İn Juvenile Idiopathic Arthritis?

Öz

This study explores the relationship between disease activity and the prognostic nutritional index (PNI) in patients with juvenile idiopathic arthritis (JIA) and aims to assess the potential of PNI as a prognostic biomarker in JIA. Patients diagnosed with oligoarticular and polyarticular JIA were categorized into two groups based on the Juvenile Arthritis Disease Activity Score (JADAS): those in remission or with low disease activity, and those with moderate to high disease activity. Demographic, clinical, and laboratory characteristics, along with PNI values, were compared between the two groups.The study included 106 patients with oligoarticular and polyarticular JIA, with a median age of 5.95 years and 67(63.2%) were female. Uveitis was observed in 18 patients (17%) and family history in 14 patients (13.2%).. Approximately two-thirds (n=69) were diagnosed with oligoarticular JIA, while 33.1% (n=35) had polyarticular JIA. Based on JADAS scores at the 12-month follow-up, two groups emerged: Group 1, with patients in remission or with low disease activity, and Group 2, with patients experiencing moderate to high disease activity. Corticosteroid treatment was administered to 52 patients (58.4%) in group 1 and 16 patients (94.1%) in group 2. The use of biologic DMARDs was significantly higher in group 2 and etanercept was the most preferred agent. Biologic DMARDs were changed in 9 patients (11.4%), while 15 patients (14.2%) achieved remission without treatment. The median PNI value did not differ significantly between the groups. PNI does not adequately reflect disease activity in JIA and should not be considered a reliable prognostic tool for this patient population.

Anahtar Kelimeler

Juvenile idiopathic arthritis, prognosis, prognostic nutritional index

Kaynakça

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